We will discuss “Delivery by caesarean section and childhood cancer: a nationwide follow-up study in three countries” by Momen and co-workers from 28 May 2014. The paper will be made free-to-view for four weeks from 19 May 2014.
Start date: 28 May 2014 (the discussion will open for 7 days)
First hosted discussion session(s) starts at: Noon EST/ 5pm UK time (GMT+1)
The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of each month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time.
All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).
The discussion points are attached below (quoted from the published manuscript)
|Scenario A paediatric oncologist at your institute observes that a substantial proportion of her cancer patients were born by caesarean section. She asks if you know of any data suggesting an association between caesarean birth and childhood cancers.|
Description of research
|Participants||Children born in Denmark (1973–2007), Sweden (1973–2008) and Finland (1987–2007) with a recorded mode of birth|
|Intervention||Birth by caesarean section (elective, unplanned or unknown)|
|Comparison||Children not born by caesarean section|
|Outcomes||All childhood cancers. Childhood cancer, stratified by subtype|
|Study design||Retrospective cohort|
- Do the hypotheses with regard to caesarean section and childhood cancer favour an association or causation? How does one prove causation?
- What are the advantages of a retrospective cohort design? What other study type might have been used?
- What potential confounding factors were not addressed in the adjusted models?
- How does confounding by indication relate to the association between caesarean section and testicular cancer?
- If a significant association between caesarean section and testicular cancer had been found, would that affect your clinical practice?
- Based on this work, how would you answer the paediatric oncologist in the scenario above? (Data S1)
For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHost, this blog and our Facebook page to receive news about #BlueJC.